Volume 4, Issue 4 ( Journal of Clinical and Basic Research (JCBR) 2020)
jcbr 2020, 4(4): 27-33 |
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Khorsandi B, Khoshnam Rad M, Moradi M, Mohammadnejad F. Early Manifestations of Acute Renal Failure in a Pregnant Woman with Diabetes. jcbr 2020; 4 (4) :27-33
URL: http://jcbr.goums.ac.ir/article-1-278-en.html
URL: http://jcbr.goums.ac.ir/article-1-278-en.html
1- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
2- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3- Counseling Center for Midwifery and Reproductive Health, Golestan University of Medical Sciences, Gorgan, Iran
4- Golestan University of Medical Sciences, Gorgan, Iran
2- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3- Counseling Center for Midwifery and Reproductive Health, Golestan University of Medical Sciences, Gorgan, Iran
4- Golestan University of Medical Sciences, Gorgan, Iran
Abstract: (2666 Views)
Background: Diabetes is a major risk factor for acute renal failure, which is commonly seen during pregnancy. Patients with kidney failure are at significant risk for adverse pregnancy outcomes, and pregnancy may accelerate the progression of kidney disease in these patients. We herein report a pregnant woman with early manifestations of kidney failure during pregnancy.
Case description: The patient was a 39-year-old G2P1L1 woman with a gestational age of 14 weeks and 4 days who presented with edema and hypoglycemia. The patient had overt pre-orbital edema and less severe generalized edema. Finally, due to the patient's conditions based on diabetes mellitus under insulin therapy, edema, proteinuria and high creatinine level (1.5 mg/dl) in the past two weeks, pregnancy was terminated as recommended by the medical commission and after obtaining informed consent from the patient.
Conclusion: Diabetes is an important risk factor for acute renal failure. Women with kidney failure are more likely to experience adverse pregnancy outcomes. Diabetic women who consider becoming pregnant should be first evaluated by a gynecologist and nephrologist and receive specialized advice. Given the complexity of care in affected women, a multidisciplinary approach is needed to achieve the best pregnancy outcome.
Case description: The patient was a 39-year-old G2P1L1 woman with a gestational age of 14 weeks and 4 days who presented with edema and hypoglycemia. The patient had overt pre-orbital edema and less severe generalized edema. Finally, due to the patient's conditions based on diabetes mellitus under insulin therapy, edema, proteinuria and high creatinine level (1.5 mg/dl) in the past two weeks, pregnancy was terminated as recommended by the medical commission and after obtaining informed consent from the patient.
Conclusion: Diabetes is an important risk factor for acute renal failure. Women with kidney failure are more likely to experience adverse pregnancy outcomes. Diabetic women who consider becoming pregnant should be first evaluated by a gynecologist and nephrologist and receive specialized advice. Given the complexity of care in affected women, a multidisciplinary approach is needed to achieve the best pregnancy outcome.
Article Type: Research |
Subject:
Basic medical sciences
References
1. 1.International Diabetes Federation (IDF): Diabetes Atlas. 2012. Available at: http://www.diabetesatlas.org. [Online] march 3, 2012. [Cited: march 3, 2010. [Google Scholar]
2. World Health Organization (WHO). Diabetes Facts and Figures. Availabe from: http://www.who.int/diabetes/facts/en/. [Online] march 3, 2012. [Google Scholar]
3. Aziz Z, Absetz P, Oldroyd J, Pronk NP, Oldenburg B. A systematic review of real-world diabetes prevention programs: learnings from the last 15 years. Implement Sci. 2015 Dec 15; 10:172. doi: 10.1186/s13012-015-0354-6. PMID: 26670418; PMCID: PMC4681022. [View at Publisher] [DOI] [PubMed] [Google Scholar]
4. .Mima A. Diabetic nephropathy: protective factors and a new therapeutic paradigm. J Diabetes Complications. 2013 Sep-Oct; 27(5):526-30.
https://doi.org/10.1016/j.jdiacomp.2013.03.003 [View at Publisher] [DOI] [PubMed] [Google Scholar]
5. Bienholz A, Wilde B, Kribben A. From the nephrologist's point of view: diversity of causes and clinical features of acute kidney injury. Clin Kidney J. 2015 Aug;8(4):405-14. doi: 10.1093/ckj/sfv043. Epub 2015 Jul 9. PMID: 26251707; PMCID: PMC4515898.
https://doi.org/10.1093/ckj/sfv043 [View at Publisher] [DOI] [PubMed] [Google Scholar]
6. Webster P, Lightstone L, Mckay DB et al. Pregnancy in chronic kidney disease and kidney transplantation. Kidney Int. 2017; 91(5):1047-1056.
https://doi.org/10.1016/j.kint.2016.10.045 [View at Publisher] [DOI] [PubMed] [Google Scholar]
7. Zhang JJ, Ma XX, Hao L, et al. A systematic review and meta-analysis of outcomes of pregnancy in CKD and CKD outcomes in pregnancy. Clin J Am Soc Nephrol. 2015;10(11):1964-1978.
https://doi.org/10.2215/CJN.09250914 [View at Publisher] [DOI] [PubMed] [Google Scholar]
8. Cabiddu G, Castellino S, Gernone G et al. A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2016; 29(3):277-303.
https://doi.org/10.1007/s40620-016-0285-6 [View at Publisher] [DOI] [PubMed] [Google Scholar]
9. .Kendrick J, Sharma S, Holmen J, Palit S, Nuccio E, Chonchol M. Kidney disease and maternal and fetal outcomes in pregnancy. American Journal of Kidney Diseases. 2015 Jul 1; 66(1):55-9.
https://doi.org/10.1053/j.ajkd.2014.11.019 [View at Publisher] [DOI] [PubMed] [Google Scholar]
10. ewington A, Cerdá J, Mehta R. Raising awareness of acute kidney injury: aglobal perspective of a silent killer. Kidney Int. 2013; 84:457-67
https://doi.org/10.1038/ki.2013.153 [View at Publisher] [DOI] [PubMed] [Google Scholar]
11. Orlic L, Mikolasevic I, Mlicevic M, Mioc T, Golubic S, Loncaric K, et al. Analiza Akutnog Bubreznog Zatajenja Tijekom Petogodisnjeg Razdoblja U Zavodu Za Nefrologiju I dijal-izu Klinickog Bolnickog Centra Rijeka. Acta Med Croatica. 2014; 68(2): 103-9. [View at Publisher] [PubMed] [Google Scholar]
12. Patschan D, Müller GA. Acute kidney injury. J Inj Violence Res. 2015 Jan;7(1):19-26. doi: 10.5249/jivr.v7i1.604. Epub 2014 Jul 14. PMID: 25618438; PMCID: PMC4288292. [View at Publisher] [PubMed] [Google Scholar]
13. .Leblanc M, Kellum JA, Gibney RT, Lieberthal W, Tumlin J, Mehta R. Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care. 2005 Dec;11(6):533-6. doi: 10.1097/01.ccx.0000183666.54717.3d. PMID: 16292055.
https://doi.org/10.1097/01.ccx.0000183666.54717.3d [View at Publisher] [DOI] [PubMed] [Google Scholar]
14. Thomas MC, Cooper ME, Zimmet P. Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease. Nat Rev Nephrol 2016;12(2):73-81.
https://doi.org/10.1038/nrneph.2015.173 [View at Publisher] [DOI] [PubMed] [Google Scholar]
15. Tuttle KR, Bakris GL, Bilous RW, Chiang JL, de Boer IH, Goldstein-Fuchs J, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Diabetes Care 2014;37(10):2864-83.
https://doi.org/10.2337/dc14-1296 [View at Publisher] [DOI] [PubMed] [Google Scholar]
16. McMullan CJ, Lambers Heerspink HJ, Parving HH, Dwyer JP, Forman JP, de Zeeuw D. Visit-to-visit variability in blood pressure and kidney and cardiovascular outcomes in patients with type 2 diabetes and nephropathy: A post hoc analysis from the RENAAL study and the Irbesartan Diabetic Nephropathy Trial. Am J Kidney Dis 2014;64(5):714-22.
https://doi.org/10.1053/j.ajkd.2014.06.008 [View at Publisher] [DOI] [PubMed] [Google Scholar]
17. Gheith O, Farouk N, Nampoory N, Halim MA, Al-Otaibi T. Diabetic kidney disease: world wide difference of prevalence and risk factors. J Nephropharmacol 2016;5(1):49-56.
https://doi.org/10.4103/1110-9165.197379 [View at Publisher] [DOI] [PubMed] [Google Scholar]
18. Osman M, Shigidi M, Ahmed H, Abdelrahman I, Karrar W, Elhassan E, Shwaib H, Ibrahim R, Abdalla M. Pattern and outcome of acute kidney injury among Sudanese adults admitted to a tertiary level hospital: a retrospective cohort study. Pan Afr Med J. 2017 Sep 29;28:90. doi: 10.11604/pamj.2017.28.90.11054. PMID: 29255560; PMCID: PMC5724955.
https://doi.org/10.11604/pamj.2017.28.90.11054 [View at Publisher] [DOI] [PubMed] [Google Scholar]
19. .Malik E, Abdalla A, Babiker A. Teachers-cen-tred distribution of praziquantel to control schistosomiasis in Gezira State, Sudan. Public Health Open J. 2016; 1(1): 8-11.
https://doi.org/10.17140/PHOJ-1-103 [DOI] [Google Scholar]
20. Eltayeb NM, Mukhtar MM, Mohamed AB. Epidemiology of schistosomiasis in Gezi-ra area Central Sudan and analysis of cyto-kine profiles. Asian Pac J Trop Med. 2013; 6(2): 119-25. https://doi.org/10.1016/S1995-7645(13)60006-1 [View at Publisher] [DOI] [PubMed] [Google Scholar]
21. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. The New England jour-nal of medicine. 2004; 351(13): 1296 -305.
https://doi.org/10.1056/NEJMoa041031 [View at Publisher] [DOI] [PubMed] [Google Scholar]
22. Huen SC, Parikh CR. Predicting acute kid-ney injury after cardiac surgery: a system-atic review. Ann Thorac Surg. 2012; 93(1): 337-47. https://doi.org/10.1016/j.athorac-sur.2011.09.010 PMID:22186469
https://doi.org/10.1016/j.athoracsur.2011.09.010 [View at Publisher] [DOI] [PubMed] [Google Scholar]
23. Vannevel V, Claes K, Baud D et al. Preeclampsia and longterm renal function in
women who underwent kidney transplantation. Obstet Gynecol.2018; 131:57.
https://doi.org/10.1097/AOG.0000000000002404 [View at Publisher] [DOI] [PubMed] [Google Scholar]
24. Liu Y, Ma X, Zheng J, Liu X, Yan T. Pregnancy outcomes in patients withacute kidney injury during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2017; 17:235.
https://doi.org/10.1186/s12884-017-1402-9 [View at Publisher] [DOI] [PubMed] [Google Scholar]
25. Maria L. Gonzalez Suarez, Andrea Kattah, Joseph P. Grande, and Vesna Garovic. Renal Disorders in Pregnancy: Core Curriculum 2019. Am J Kidney Dis.2018; 73(1):119-130.
https://doi.org/10.1053/j.ajkd.2018.06.006 [View at Publisher] [DOI] [PubMed] [Google Scholar]
26. Nevis IF, Reitsma A, Dominic A, et al. Pregnancy outcomes in women with chronic kidney disease: a systematic review. Clin J Am Soc Nephrol. 2011;6(11):2587-2598.
https://doi.org/10.2215/CJN.10841210 [View at Publisher] [DOI] [PubMed] [Google Scholar]
27. Kattah A, Milic N, WhiteW, Garovic V. Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia. Am J Physiol Regul IntegrComp Physiol. 2017;313(4): R418-R424.
https://doi.org/10.1152/ajpregu.00508.2016 [View at Publisher] [DOI] [PubMed] [Google Scholar]
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